How do you not take this stuff home with you?

[raianne]

So I am one month into my accelerated BSN program. My patient in clinical today was an end stage cancer patient with a rectolady partsl fistula. I haven't ever dealt with a patient like this before, my first two patients were hysterectomy patients who were healthy and up and walking, and I knew they were getting better. This patient is dying.

I was in the room today when the doctor came and told this patient's family that she needed hospice. They were holding out hope that she would get well enough for a clinical trial, but her cancer had never responded to treatment and none of her doctors had ever come right out and told them that she wasn't going to get better. This doctor told them that, and everyone was crying and it was so sad. I did not cry in the patient's room or in front of the family or doctor, and I'm kind of proud of myself for that. I did go to the bathroom afterwards and have a moment of crying, but I got myself together quickly.

This woman knows her name but she's not oriented to place or time. When we move her just a little bit to clean underneath her, even though she is heavily medicated for pain, she screams and cries and begs us to stop hurting her and prays to die. It's really hard to ignore the pleas of someone who's begging you to stop hurting them, and the only way that I am able to is that I know we are doing it to help her. My questions are: How do you not think about this stuff after you go home? Is there a way to leave it at work, to mentally distance yourself from what you're doing, and is that a good thing to do? Is it something I will learn in time?

[puravidaLV]

It is what it is, has been since we could touch our pinky to our thumb. Take from it what you can, learn from it, and move on. Trust me when I say that probably won't be the first time your exposed to a sad situation...because in the hospital...I've come to terms that they pretty much all are.

I hate to do a Scrubs link...but:

leave it at the office.

[One2gofst]

It is what it is, has been since we could touch our pinky to our thumb. Take from it what you can, learn from it, and move on. Trust me when I say that probably won't be the first time your exposed to a sad situation...because in the hospital...I've come to terms that they pretty much all are.

I hate to do a Scrubs link...but:

leave it at the office.

And in Spanish, no less

[BellsRNBSN]

I'm one month into an ABSN program as well and this is something we have addressed in my class. Some of my classmates have been exposed to similar situations and are also having trouble leaving it at the hospital and not taking it home. At my clinical yesterday one of my nurse's patients was a little old lady with two stage 4 ulcers on her backside and she would cry and beg us to stop hurting her every time we had to move her. I still can't get the image of her crying out of my head.

It's awful to feel so helpless and like you're causing pain to someone who is already in such a physically and emotionally vulnerable state. We're new to this, so obviously we're going to be emotional at first, but I'm absolutely positive that it's something that gets better with time. Use that empathy to do everything you can to help and make your patient as comfortable as possible.

You're HUMAN, and as long as you're not sobbing in front of patients or their families, I see it as a good thing. You obviously care about your patients and you're not yet jaded or burned out. I don't know about you, but I'd rather have a nurse who gets a little teary-eyed with me if I were the patient receiving bad news, rather than a cold, stand-offish nurse. Just my personal preference though!

Best of luck to you, and hopefully this is something we will learn in time!

[cmonkey]

Your hospice pt needs better pain control for one thing. I hope they manage to deal with that.

People die. It isn't always drifting off to sleep surrounded by loved ones. Some people fight tooth and nail and never, ever accept that it's happening. Some just decide it's time and go. Most people are somewhere in between, I imagine. All you can do is your best for them. Advocate, touch, advocate some more. Learn good things from them, and take that home instead of the bad, if you have to take anything.